• 호스피스학술지
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• 제1권1호
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• pp.46-69
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• 2001

Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

• Perspectives in Nursing Science
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• 제16권2호
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• pp.55-64
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• 2019

Purpose: This study examined the knowledge and perception of hospice-palliative care and terminal care stress among pediatric nurses, and the relationships among these variables. Methods: In this descriptive research study, 154 pediatric nurses who experienced terminal care at least once were surveyed. This study used three scales, including the Palliative Care Quiz for Nursing (PCQN), Perception of Hospice-Palliative Care, and Terminal care stress. Data analyses using SPSS 22.0 included descriptive statistics, independent t-test, one-way ANOVA, Mann-Whitney U test, Pearson's correlation coefficient, and stepwise multiple linear regression. Results: Terminal care stress experienced by the pediatric nurses was significantly related to the perception of hospice-palliative care; the hospice-palliative care education program enhanced the knowledge and perception of hospice-palliative care. Conclusion: Hospice-palliative care education programs should be developed and provided for pediatric nurses to improve pediatric hospice-palliative care. Additionally, further research on this topic is required because the present results are inconsistent with previous and current researches.

• 대한간호
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• 제23권3호통권126호
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• pp.51-56
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• 1984

• Asian Pacific Journal of Cancer Prevention
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• 제13권6호
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• pp.2861-2866
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• 2012

Background: The aim of our study was to assess the practical utility of the palliative prognostic index (PPI) as a prognostic tool used by nurse specialists in a hospice consultation setting in Taiwan. Methods: In total, 623 terminal cancer patients under hospice consultation care from one medical center in northern Taiwan were enrolled between January 1 and June 30, 2011. PPI was assessed by a nurse specialist at first hospice consultation and patients categorized into groups by prognosis (good, intermediate, poor). Patient survival was analyzed retrospectively to determine significance of between-group differences. Results: By PPI sum score, 37.2% of patients were in the good prognosis group, 18% in the intermediate prognosis group and 44.8% in the poor prognosis group. The death rates were 56%, 81.2% and 89.6% and median survivals were 76, 18 and 7 days, respectively. The hazard ratio was 0.19 (95% confidence interval [CI] 0.10-0.24, p<0.001) for the poor versus good prognosis group and 0.54 (95% CI 0.43-0.69, p<0.001) for the poor versus intermediate prognosis group. The sensitivity and specificity for the poor prognosis group was 66% and 71%; the positive predictive value and negative predictive value were 81% and 52%, respectively, to predict patient death within 21 days (area under the curve of the receiver operating characteristic was 0.68). Conclusions: Assessment by PPI can accurately predict survival of terminal cancer patients receiving hospice consultation care. PPI is a simple tool and can be administered by nurse members of hospice consultation teams.

• 한국호스피스완화의료학회:학술대회논문집
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• 한국호스피스완화의료학회 2004년도 정기총회 및 하계학술대회
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• pp.100-102
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• 2004

Under the current medical system, a terminal patient and his/her family who are neglected inevitably face various aspects of crises including not only physical, but also psychological, social, economic, spiritual and legal problems. Nurses often look after many terminal patents with these types of complicated problems. Therefore, educating the nurses who will take care of such patents would greatly reduce stress so the patents end could their lives in peace and without losing their dignity. This research is a quasi experimental study of nonequivalent control group. A pretest-posttest design where a basic education program is developed for nurses, who frequently treat terminal patents, to understand the importance of the role of hospice and to apply their understandings to treat terminal lancer patents. A sample of the nurses were taken from those who were working in general wards at two general hospitals in Seoul during October, 2003${\sim}$December 2003. The study was composed of 46 experimental group and 43 control group. A basic hospice education program was developed by taking emphasized and overlapping parts from advanced practice hospice nurses education course, short-term education course, an extensive literature survey and by consulting three professionals as well. With the group of 5 professors with vast experiences in oncolgy, 5 nursing administrator, 3 nursing practitioner, the tentative first version of the program was developed and reviewed. Afterwards, by utilizing person to person interviews with 2 head nurses experienced with terminal patients, 1 nurse in charge of hospice, 1 nurse on the contents of the program, and a person to person rating on the educating medium by a nurse were performed. The final version of a basic education program was developed after the second revision. The hospice basic education program consists of introduction to hospice, hospice and commucation, management of pain for terminal cancer patients, physical management for terminal cancer patients, socio-psycological caring of terminal cancer patients and management of death and separation. Total education time was four hours organized into 50 minutes of instruction and 10 minutes of break. $Powerpoint^{(R)}$ software was used as the education medium. As research tools, "Knowledge on Hospice" was developed by the author after receiving a review from one expert. "Attitude of Hospice Nursing" was revised Kim(2001)'s attitude measuring tool which was based on Wang(1998), Kwon(1989), Park and Sung(1991)'s tool. "Liability on nursing terminal patients" was used as developed by Zarits(1980) and Mongomory(1985) translated by Lee(1985). For collecting data, preliminary investigation prior to 1 week of the hospice basic education program and post-investigations after 1 week and 4 weeks of the education were carried out for the nurses at a general ward who understood and agreed on the purpose of the program. Collected data were analyzed throughout t-test, $x^2-test$, Manova test and Bonferroni correction in $SAS^{(R)}$ program. The summary of the investigation is as follows: Hypothesis 1: "Educated experimental group would possess more knowledge on hospice compared to the un-educated control group" was supported after 1 (F=12.14, p=.00) and 4 (F=5.3, p=.02) weeks of education. Hypothesis 2: "Educated experimental group would take a positive attitude toward hospice nursing compared to the un-educated control group" was supported after 1(F=3.92, p=.05) and 4(F=5.05, p=.02) weeks of education. Hypothesis 3: "Educated experimental poop would feel less liability compared to the un-educated control group in nursing terminal cancer patients' was rejected. In this study, it was found that knowledge on hospice was significantly important. By applying hospice basic education programs to nurses, the education program helped nurses to take a positive attitude toward terminal patients. It was, however, seen that the education program had no effect on alleviating liability in nursing terminal patients. Therefore, it is expected that this educational program would help hospices and nurses at general wards to understand the concept and the role of hospice so that terminal patents, now neglected under current medical system, would be able to end their lives in peace.

• 대한간호학회지
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• 제29권3호
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• pp.576-584
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• 1999

The purpose of this study was to develop an education program for hospice care and to examine the effect of the program. The education program for hospice care was developed based on the philosophy and principle of Hospice and integrated with various professional areas related to the problems with which terminal patients and their family might be associated. The program was continued for 16 weeks and consisted of lectures and practices. The courses of this program were The Concept and Principle of Hospice, The Role of the Hospice Nurse, The Characteristics of Terminal Disease, Physical Care in Terminal Patients, Death Orientation, Psychological care for Terminal Patients, Spiritual care for Terminal Patients, and Care for the Family. To identify the effect of the education program for hospice care, the difference in death orientation of subjects between the pre and post performance of the education program was examined using the t-test. The finding of this statistic indicated that this education program for hospice care was effective in terms of changing the death orientation of subjects with positive direction. The education program for hospice care was performed several times at Kwangrim Hospice Missionary, Chungbuk University Hospital, and Wooam Church. Case studies were reported for a description of content of hospice care experienced by subjects after the performance of education, put this at the beginning 8 the sentence. In conclusion, the education program for hospice care was developed effectively. Therefore, this program should be used to educate and activate the subjects in community to be participants in hospice care.

• 대한간호
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• 제37권1호
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• pp.98-106
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• 1998

The purpose of this study was to investigate what effect providing the hospice care team with hospice education programs had on the death orientation. The subjects of study were 28 volunteers. 14 nurses. 30 clergies who registered on hospice education programs from Aug. 6th. 1996 to May 20th. 1997. The data were analysed by descriptive analysis. ANOVA. Duncan test. paired t-test. The results of the study can be summarized as follows ; 1. The degrees of death orientation were 85.70 in volunteers group. 84.31 in nurses group. and 73.00 in clergies group. So. clergies group has more positive death orientation than others(F=6.33. p=. 000). The degree of death orientation showed significant differences between age groups(F=5.78. p =.002). and religiosity(t=3.92. p=.000). There were no significant differences between the degree of death orientation and the others general characteristics of subjects. 2. The mean of death orientation was 80.04 before hospice education programs. but was 75.56 after hospice education programs(t= 3.92. p= .000). In conclusion. the subjects who received the hospice education programs showed the positive change in the degree of the death orientation. Therefore. it has been judged that education programs has been prerequisite in positive death orientation for hospice care. Furthermore. all of the hospice care members those who complete the hospice education program. will be performed efficient hospice care intervention for dying patients and their families.

• 간호행정학회지
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• 제20권3호
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• pp.322-331
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• 2014

Purpose: The purpose of this study was to identify factors influencing job satisfaction in hospice nurses. The focus was on emotional labor and burnout. Methods: Between September 30 and October 18, 2013, hospice nurses (n=63) in 5 hospitals in 4 cities completed measures of emotional labor, burnout, and job satisfaction. Data were collected using questionnaires and analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and multiple regression with the SPSS/Win 21.0 program. Results: The mean score per item for emotional labor was 3.0, the mean of burnout score was 2.7, and the mean job satisfaction score was 3.4. Emotional labor showed a positive correlation with burnout (r=.61), and a negative correlation with job satisfaction (r=-.52). Burnout showed a negative correlation with job satisfaction (r=-.64). The factors influencing job satisfaction were burnout (${\beta}$=-.65, p<.001) and clinical experience (${\beta}$=.25, p=.007). Burnout and clinical experience explained 57.0% of the variance in hospice nurses' job satisfaction. Conclusion: The findings of this study indicate a need to develop strategies to prevent burnout and control emotional labor in order to increase job satisfaction for hospice nurses.

• 호스피스학술지
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• 제2권1호
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• pp.75-86
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• 2002

Prupose: The purpose of this study was to identify signs and symptoms of hospice patients during their dying processes. Method: The subjects of this study were 76 patients who received hospice care services in 2 different hospice care programs in Seoul area. Data was obtained from January, 1999 to June, 2001 by hospice nurse's observation, interviews with patient's primary caregiver and hospice volunteers, patient's self report, nursing records and questionnaires which had been developed by selecting from various references and refining them based on the result of preliminay studies. The collected data were analyzed with the SPSS PC+ program and content analysis. Results: Mean lengths of hospice patient's dying process were 3.6 days. Physical signs and symptoms of hospice patients during their dying processes were 'increased sleep'(89.5%), 'decreased oral intake of food'(88.2%) and 'liquids'(86.8%), 'change of respiration'(82.9%), 'decreased urine output'(80.3%), 'cold extremities'(69.7%), 'death rattle'(67.1%), 'cyanosis'(57.9%), 'restlessness'(55.3%), etc. And psychological, spiritual and social signs and symptoms were 'decreased interpersonal relationships'(61.8%), 'panorama of memories from childhood'(60.5%), 'experiences as like hallucination'(56.5%), 'saying bye with family'(69.7%), 'forgiveness', 'make a will', etc. Experiences as like hallucination were seemed not as dream but reality were shown by 43 dying patients. They had experienced to see and to talk with their deceased mother(18.6%) and/or relatives(30.2%), angels(20.9%), heaven(11.6%), old house in which they had lived, someone from the world beyond with black clothes, etc. Conclusion: The above results indicate that death of hospice patients is ongoing process with dying signs and symptoms during several days contains not only in physical aspects but also among psychological, spiritual and social aspects including family dynamics.

• 대한간호학회지
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• 제28권4호
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• pp.1027-1035
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• 1998

The purpose of this study is to develop the first domestic professional hospice educational program. We investigated the present condition of Korean hospice education and analyzed the prerequisite need for a dedicated hospice course in the professional education process. Research was conducted between June and November 1996 for nursing professors teaching at each nursing education institute to find out how much hospice is being discussed and by whom, in which course it is being discussed, and also to find out the contents that needed to be included in the professional education process. From a total of 49 colleges(29 three year colleges, 20 four year colleges) out of 99, 162 nursing professors replied, the collection rate was 49.5%. The conclusions are as follows ; 1. The present condition of the hospice nursing education. 1) Whether hospice is included in the education program. \circled1 89.65% of 3 year colleges and 90% of 4 year colleges included hospice education in their education program. \circled2 In graduate studies three schools included hospice in their program and three schools expressed their plans to include hospice education 2) Hospice related education were commonly discussed in adult nursing(26.3%), fundamental nursing(22.8%), and psychiatric nursing(20.2%). In 3 year colleges its commonly discussed in the first and second year and in 4 year colleges it is taught in the second and third year. 3) Hospice related theory/practical education hours were averages of 6.5/7.0 hrs in 3 year colleges and 14.2/11.3 hrs in 4 year colleges. 4) The majority of professors in charge of hospice education were in the following order adult nursing, psychiatric nursing, and fundamental nursing. 5) The courses that are thought to be adequate to manage hospice related education were adult nursing(29.3%), community health nursing(21.7%) and the desired method of education was the method currently being used (36.5%). 2. The demand for hospice nursing education. 1) Over 70% demanded professional hospice education program, the highest demand was for the value and meaning of life followed by the role and qualification of the hospice team and the mental maintenance of a dying patient. 25 categories showed over 90% demand. 2) The highest demand was for the value and meaning of life (98.2%) and the lowest demand were for danjeon breathing(71.0%)and acupuncture(71.0%). 3) Other contents that need to be discussed in the professional hospice education program were hospice nursing, the attitude and reaction of death, bereavement care, and the prospects of hospice.